Comparative Analysis of Efficacy and Complication of Nasojejunal Tube and Jejunostomy Feeding Tube in Patient Undergone upper GI Perforation Surgery

Abstract

Introduction: Upper gastrointestinal perforations represent critical surgical emergencies characterized by a rupture in the wall of the upper GI tract, including the esophagus, stomach, and duodenum. These perforations often result from peptic ulcer disease (PUD), necessitating prompt surgical intervention to prevent severe morbidity and mortality. Post-operative nutritional support is crucial for patient recovery, and so for enteral feeding with Nasojejunal and Jejunostomy feeding tubes being the primary methods can be employed. NJ tubes are inserted through the nasal passage into the jejunum, whereas Jejunostomy feeding tubes are surgically placed directly into the jejunum through the anterior abdominal wall.

Objectives: This prospective study aimed to evaluate and compare efficacy and complications of Nasojejunal feeding tube and Jejunostomy feeding tube in patient undergone upper Gl perforation surgery at G.S.V.M. Medical College, Kanpur, from December 2022 to June 2024.

Methods: The study conducted on 100 patients admitted in LLR Hospital, GSVM Medical College, Kanpur with upper GI perforation and have Been managed operatively along with insertion of enteral feeding tube for comparative analysis of efficacy and complication of NasoJejunal feeding tube And Feeding jejunostomy tube.

Results: Our study comprised 100 patients, with 50 being administered Feeding jejunostomy and other 50 being administered nasojejunal feeding Tubes randomly after primary repair of perforation. The mean operative time for feeding Jejunostomy was 92.66 minutes, and for nasojejunal feeding, it was 78.98 Minutes. The total mean duration of tube feeding in jejunostomy was 7.32 Days, whereas in nasojejunal feeding tube, it was 6.04 days. The mean Duration for removing the feeding tube was 9.60 days in feeding jejunostomy And 7.46 days in the nasojejunal feeding tube. The mean post-operative Hospital stay was 10.60 days in feeding jejunostomy and 8.46 days in Nasojejunal feeding tube. Tube dislocation and tube obstruction in feeding Jejunostomy occurred in 4% of the cases respectively, whereas in nasojejunal Feeding tube cases, it occurred in 2% cases respectively. Other tube related Complications occur less in nasojejunal group.

Conclusion: Nasojejunal feeding tubes demonstrated slightly better management outcomes and fewer complications compared to Jejunostomy feeding tubes in patients undergoing upper GI perforation surgery. Further studies are warranted to substantiate these findings.